STUDY OBJECTIVE Cervical insufficiency occurs in 0.1-1?% of all pregnancies and is associated with a high risk of second trimester abortion and/or preterm delivery 1. The laparoscopic encerclage is highly recommended for previous failed vaginal encerclage and is superior to laparotomy approach in terms of low morbidity and faster recovery 2. Laparoscopic encerclage in pregnancy is more challenging as compared to the non pregnant state. This is due to enlarged uterine size, engorged uterine vessels and inability to use a uterine manipulator. The standardization and description of the technique are the main objectives of this video (Video 1). We have described the surgery in 6 steps, which could make this procedure easier and safer. DESIGN A step-by-step video demonstration of the technique (Video 1). SETTING Paul's Hospital, Centre for advanced endoscopy &amp; infertility treatment, Kochi, India. A 29-year-old pregnant woman, G3A2, at 13 weeks period of gestation, with history of two second trimester abortions dueve. Behavioral studies investigating fundamental cognitive abilities provide evidence that processing speed accounts for large proportions of performance variability between individuals. Processing speed decline is a hallmark feature of the cognitive disruption observed in healthy aging and in demyelinating diseases such as multiple sclerosis (MS), neuromyelitis optica, and Wilson's disease. Despite the wealth of evidence suggesting a central role for processing speed in cognitive decline, the neural mechanisms of this fundamental ability remain unknown. Intact neurovascular coupling, acute localized blood flow increases following neural activity, is essential for optimal neural function. We hypothesized that efficient coupling forms the neural basis of processing speed. Because MS features neural-glial-vascular system disruption, we used it as a model to test this hypothesis. To assess the integrity of the coupling system, we measured blood-oxygen-level-dependent (BOLD) signal in healthy controls (HCs) and MS patients using a 3T MRI scanner while they viewed radial checkerboards that flickered periodically at 8 Hz. To assess processing speed and cognitive function, we administered a battery of neuropsychological tests. While MS patients exhibited reduced ΔBOLD with reductions in processing speed, no such relationships were observed in HCs. To further investigate the mechanisms that underlie ΔBOLD-processing speed relationships, we assessed the physiologic components that constitute ΔBOLD signal (i.e., cerebral blood flow, ΔCBF; cerebral metabolic rate of oxygen, ΔCMRO2; neurovascular coupling ratio) in speed-preserved and -impaired MS patients. While ΔCBF and ΔCMRO2 showed no group-differences, the neurovascular coupling ratio was significantly reduced in speed-impaired MS patients compared to speed-preserved MS patients. Together, these results suggest that neurovascular uncoupling might underlie cognitive slowing in MS and might be the central pathogenic mechanism governing processing speed decline. Human visual cortex is partitioned into different functional areas that, from lower to higher, become increasingly selective and responsive to complex feature dimensions. Here we use a Representational Similarity Analysis (RSA) of fMRI-BOLD signals to make quantitative comparisons across LGN and multiple visual areas of the low-level stimulus information encoded in the patterns of voxel responses. Our stimulus set was picked to target the four functionally distinct subcortical channels that input visual cortex from the LGN two achromatic sinewave stimuli that favor the responses of the high-temporal magnocellular and high-spatial parvocellular pathways, respectively, and two chromatic stimuli isolating the L/M-cone opponent and S-cone opponent pathways, respectively. Each stimulus type had three spatial extents to sample both foveal and para-central visual field. With the RSA, we compare quantitatively the response specializations for individual stimuli and combinations of stimuli in each area and how these change across visual cortex. First, our results replicate the known response preferences for motion/flicker in the dorsal visual areas. In addition, we identify two distinct gradients along the ventral visual stream. In the early visual areas (V1-V3), the strongest differential representation is for the achromatic high spatial frequency stimuli, suitable for form vision, and a very weak differentiation of chromatic versus achromatic contrast. Emerging in ventral occipital areas (V4, VO1 and VO2), however, is an increasingly strong separation of the responses to chromatic versus achromatic contrast and a decline in the high spatial frequency representation. These gradients provide new insight into how visual information is transformed across the visual cortex. Environmental conditions bias our perception of other peoples' facial emotions. This becomes quite relevant in potentially threatening situations, when a fellow's facial expression might indicate potential danger. The present study tested the prediction that a threatening environment biases the recognition of facial emotions. To this end, low- and medium-expressive happy and fearful faces (morphed to 10%, 20%, 30%, or 40% emotional) were presented within a context of instructed threat-of-shock or safety. https://www.selleckchem.com/products/ono-ae3-208.html Self-reported data revealed that instructed threat led to a biased recognition of fearful, but not happy facial expressions. Magnetoencephalographic correlates revealed spatio-temporal clusters of neural network activity associated with emotion recognition and contextual threat/safety in early to mid-latency time intervals in the left parietal cortex, bilateral prefrontal cortex, and the left temporal pole regions. Early parietal activity revealed a double dissociation of face-context information as a function of the expressive level of facial emotions When facial expressions were difficult to recognize (low-expressive), contextual threat enhanced fear processing and contextual safety enhanced processing of subtle happy faces. However, for rather easily recognizable faces (medium-expressive) the left hemisphere (parietal cortex, PFC, and temporal pole) showed enhanced activity to happy faces during contextual threat and fearful faces during safety. Thus, contextual settings reduce the salience threshold and boost early face processing of low-expressive congruent facial emotions, whereas face-context incongruity or mismatch effects drive neural activity of easier recognizable facial emotions. These results elucidate how environmental settings help recognize facial emotions, and the brain mechanisms underlying the recognition of subtle nuances of fear.